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Massana Roquero D, Holton GH, Ge TJ, Kornberg Z, Mach KE, Rodriguez G, La V, Lau H, Sun R, Chang TC, Conti S, Liao JC. Disrupting Biofilms on Human Kidney Stones-A Path Toward Reducing Infectious Complications During Stone Surgery. Adv Healthc Mater 2025:e2403470. [PMID: 40012448 DOI: 10.1002/adhm.202403470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2024] [Revised: 11/22/2024] [Indexed: 02/28/2025]
Abstract
Kidney stones are a common disorder associated with significant morbidity and often requires surgical intervention. Pathogenic bacteria are found in almost 40% of stones, where they form biofilms that are protected from systemic antibiotic treatments. Stone surgeries disperse biofilms resulting in up to 30% of patients developing postoperative urinary tract infections and 15% developing sepsis. This work is based on the hypothesis that chitosan, an antimicrobial polymer, can eradicate bacterial biofilms present in the stone and potentially serve as an adjunct to irrigation during stone surgery. First, fresh patient-derived kidney stone fragments (n = 56) are collected from stone surgeries. A total of 32% of stones are colonized, predominantly with Enterococcus faecalis, Escherichia coli, and Proteus mirabilis. A short, clinically relevant, chitosan treatment reduces the bacterial burden on colonized stones by over 90% in all specimens tested, regardless of stone composition and bacterial strain. To assess this approach toxicity, ex vivo human ureters and in vivo porcine bladders are exposed to topical chitosan irrigation. No toxic or pathological abnormalities other than urothelial exfoliation are noted. In conclusion, chitosan effectively disrupts kidney stone-associated bacterial biofilms with minimal urothelial toxicity and may provide an effective and safe approach to reducing postoperative complications.
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Affiliation(s)
- Daniel Massana Roquero
- Department of Urology, Stanford University School of Medicine, Stanford, CA, 94305, USA
- Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, 94304, USA
| | - Grace H Holton
- Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, 94304, USA
| | - T Jessie Ge
- Department of Urology, Stanford University School of Medicine, Stanford, CA, 94305, USA
| | - Zachary Kornberg
- Department of Urology, Stanford University School of Medicine, Stanford, CA, 94305, USA
| | - Kathleen E Mach
- Department of Urology, Stanford University School of Medicine, Stanford, CA, 94305, USA
- Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, 94304, USA
| | - Gabriella Rodriguez
- Department of Urology, Stanford University School of Medicine, Stanford, CA, 94305, USA
- Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, 94304, USA
| | - Vinh La
- Department of Urology, Stanford University School of Medicine, Stanford, CA, 94305, USA
| | - Hubert Lau
- Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, 94304, USA
- Department of Pathology, Stanford University School of Medicine, Stanford, CA, 94305, USA
| | - Ryan Sun
- Department of Urology, Stanford University School of Medicine, Stanford, CA, 94305, USA
| | - Timothy C Chang
- Department of Urology, Stanford University School of Medicine, Stanford, CA, 94305, USA
- Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, 94304, USA
| | - Simon Conti
- Department of Urology, Stanford University School of Medicine, Stanford, CA, 94305, USA
| | - Joseph C Liao
- Department of Urology, Stanford University School of Medicine, Stanford, CA, 94305, USA
- Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, 94304, USA
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Wang Y, Yang J, Amier Y, Yuan D, Xun Y, Yu X. Advancements in Nanomedicine for the Diagnosis and Treatment of Kidney Stones. Int J Nanomedicine 2025; 20:1401-1423. [PMID: 39925679 PMCID: PMC11805677 DOI: 10.2147/ijn.s504318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2024] [Accepted: 01/17/2025] [Indexed: 02/11/2025] Open
Abstract
Kidney stones constitute a common condition impacting the urinary system. In clinical diagnosis and management, traditional surgical interventions and pharmacological treatments are primarily utilized; however, these methods possess inherent limitations. Presently, the field of nanomedicine is undergoing significant advancements. The application of nanomaterials in biosensors enables the accurate assessment of urinary ion composition. Furthermore, contrast agents developed from these materials can improve the signal-to-noise ratio and enhance image clarity. By mitigating oxidative stress-induced cellular damage, nanomaterials can inhibit the formation of kidney stones and enhance the efficacy of drug delivery as effective carriers. Additionally, by modifying the physical and chemical properties of bacteria, nanomaterials can effectively eliminate bacterial presence, thereby preventing severe complications. This review explores the advancements in nanomaterials technology related to the early detection of risk factors, clinical diagnosis, and treatment of kidney stones and their associated complications.
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Affiliation(s)
- Yongqi Wang
- Department of Urology, Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China
| | - Junyi Yang
- Department of Urology, Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China
| | - Yirixiatijiang Amier
- Department of Urology, Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China
| | - Dongfeng Yuan
- Department of Urology, Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China
| | - Yang Xun
- Department of Urology, Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China
| | - Xiao Yu
- Department of Urology, Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China
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Guliy OI, Evstigneeva SS. Bacterial Communities and Their Role in Bacterial Infections. Front Biosci (Elite Ed) 2024; 16:36. [PMID: 39736004 DOI: 10.31083/j.fbe1604036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Revised: 06/07/2024] [Accepted: 06/20/2024] [Indexed: 12/31/2024]
Abstract
Since infections associated with microbial communities threaten human health, research is increasingly focusing on the development of biofilms and strategies to combat them. Bacterial communities may include bacteria of one or several species. Therefore, examining all the microbes and identifying individual community bacteria responsible for the infectious process is important. Rapid and accurate detection of bacterial pathogens is paramount in healthcare, food safety, and environmental monitoring. Here, we analyze biofilm composition and describe the main groups of pathogens whose presence in a microbial community leads to infection (Staphylococcus aureus, Enterococcus spp., Cutibacterium spp., bacteria of the HACEK, etc.). Particular attention is paid to bacterial communities that can lead to the development of device-associated infections, damage, and disruption of the normal functioning of medical devices, such as cardiovascular implants, biliary stents, neurological, orthopedic, urological and penile implants, etc. Special consideration is given to tissue-located bacterial biofilms in the oral cavity, lungs and lower respiratory tract, upper respiratory tract, middle ear, cardiovascular system, skeletal system, wound surface, and urogenital system. We also describe methods used to analyze the bacterial composition in biofilms, such as microbiologically testing, staining, microcolony formation, cellular and extracellular biofilm components, and other methods. Finally, we present ways to reduce the incidence of biofilm-caused infections.
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Affiliation(s)
- Olga I Guliy
- Institute of Biochemistry and Physiology of Plants and Microorganisms - Subdivision of the Federal State Budgetary Research Institution Saratov Federal Scientific Centre of the Russian Academy of Sciences (IBPPM RAS), 410049 Saratov, Russia
| | - Stella S Evstigneeva
- Institute of Biochemistry and Physiology of Plants and Microorganisms - Subdivision of the Federal State Budgetary Research Institution Saratov Federal Scientific Centre of the Russian Academy of Sciences (IBPPM RAS), 410049 Saratov, Russia
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Hajfathalian M, Mossburg KJ, Radaic A, Woo KE, Jonnalagadda P, Kapila Y, Bollyky PL, Cormode DP. A review of recent advances in the use of complex metal nanostructures for biomedical applications from diagnosis to treatment. WILEY INTERDISCIPLINARY REVIEWS. NANOMEDICINE AND NANOBIOTECHNOLOGY 2024; 16:e1959. [PMID: 38711134 PMCID: PMC11114100 DOI: 10.1002/wnan.1959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Revised: 03/31/2024] [Accepted: 04/01/2024] [Indexed: 05/08/2024]
Abstract
Complex metal nanostructures represent an exceptional category of materials characterized by distinct morphologies and physicochemical properties. Nanostructures with shape anisotropies, such as nanorods, nanostars, nanocages, and nanoprisms, are particularly appealing due to their tunable surface plasmon resonances, controllable surface chemistries, and effective targeting capabilities. These complex nanostructures can absorb light in the near-infrared, enabling noteworthy applications in nanomedicine, molecular imaging, and biology. The engineering of targeting abilities through surface modifications involving ligands, antibodies, peptides, and other agents potentiates their effects. Recent years have witnessed the development of innovative structures with diverse compositions, expanding their applications in biomedicine. These applications encompass targeted imaging, surface-enhanced Raman spectroscopy, near-infrared II imaging, catalytic therapy, photothermal therapy, and cancer treatment. This review seeks to provide the nanomedicine community with a thorough and informative overview of the evolving landscape of complex metal nanoparticle research, with a specific emphasis on their roles in imaging, cancer therapy, infectious diseases, and biofilm treatment. This article is categorized under: Diagnostic Tools > In Vivo Nanodiagnostics and Imaging Therapeutic Approaches and Drug Discovery > Nanomedicine for Infectious Disease Diagnostic Tools > Diagnostic Nanodevices.
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Affiliation(s)
- Maryam Hajfathalian
- Department of Biomedical Engineering, New Jersey Institute of Technology, University Heights, Newark, NJ 07102
- Division of Infectious Diseases, School of Medicine, Stanford University, Stanford, CA 94305
| | - Katherine J. Mossburg
- Department of Radiology, University of Pennsylvania, 3400 Spruce Street, 1 Silverstein, Philadelphia, Pennsylvania 19104, United States
| | - Allan Radaic
- School of Dentistry, University of California Los Angeles
| | - Katherine E. Woo
- Division of Infectious Diseases, School of Medicine, Stanford University, Stanford, CA 94305
| | - Pallavi Jonnalagadda
- Department of Bioengineering, University of Pennsylvania, Philadelphia, Pennsylvania 19104, United States
| | - Yvonne Kapila
- School of Dentistry, University of California Los Angeles
| | - Paul L. Bollyky
- Division of Infectious Diseases, Department of Medicine, Stanford University
| | - David P. Cormode
- Department of Radiology, Department of Bioengineering, University of Pennsylvania
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Kallidonis P, Peteinaris A, Veneziano D, Pietropaolo A, Pagonis K, Adamou C, Vagionis A, Al-Aown A, Liatsikos E, Somani B. Use of artificial stones in training and laboratory studies, have we found the right material? Outcomes of a systematic review from the European School of Urology. Urol Ann 2024; 16:43-51. [PMID: 38415239 PMCID: PMC10896332 DOI: 10.4103/ua.ua_112_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 12/12/2022] [Indexed: 02/29/2024] Open
Abstract
Objective In this review, we investigated the current literature to find out which artificial stones (AS) are available in endourology, and in which experimental and training schemes they are used. Materials and Methods A systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Twenty-one out of 346 studies met our inclusion criteria and are presented in the current review. The inclusion criteria were the existence of AS and their use for laboratory and training studies. Results There is a wide variety of materials used for the creation of AS. BegoStone powder (BEGO USA, Lincoln, Rhode Island) and plaster of Paris™ were used in most of the studies. In addition, Ultracal-30 (U. S. Gypsum, Chicago, IL) was also used. Other materials that were used as phantoms were AS created from plaster (Limbs and Things, UK), standardized artificial polygonal stone material (Chaton 1028, PP13, Jet 280; Swarovski), model stones consisting of spheres of activated aluminum (BASF SE, Ludwigshafen am Rhein, Deutschland), Orthoprint (Zhermack, Badia Polesine, Italy), and a combination of plaster of Paris, Portland cement, and Velmix (calcium sulfate powder). Many experimental settings have been conducted with the use of AS. Our research demonstrated nine studies regarding testing and comparison of holmium: yttrium-aluminum-garnet laser devices, techniques, and settings. Six studies were about extracorporeal shock wave lithotripsy testing and settings. Three experiments looked into treatment with percutaneous nephrolithotomy. Additionally, one study each investigated imaging perioperatively for endourological interventions, stone bacterial burden, and obstructive uropathy. Conclusion AS have been used in a plethora of laboratory experimental studies. Independent of their similarity to real urinary tract stones, they present a tremendous potential for testing and training for endourological interventions.
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Affiliation(s)
| | | | - Domenico Veneziano
- Department of Urology and Kidney Transplant, Grande Ospedale Metropolitano, Reggio Calabria, Italy
- School of Medicine, Hofstra Northwell University, New York, USA
| | - Amelia Pietropaolo
- Department of Urology, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | | | | | | | - Abdulrahman Al-Aown
- Department of Urology, Armed Forces Hospital Southern Region, Khamis Mushait, Saudi Arabia
| | - Evangelos Liatsikos
- Department of Urology, University Hospital of Rion, Patras, Greece
- Medical University of Vienna, Vienna, Austria
| | - Bhaskar Somani
- Department of Urology, University Hospital Southampton NHS Foundation Trust, Southampton, UK
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